WO2019197169A1

WO2019197169A1 - Intermediate element for retrofitting a mechanical stethoscope

Info

Publication number: WO2019197169A1
Application number: PCT/EP2019/057936
Authority: WO
Inventors: Regina Margarete Clara KIRCHNER-GOTTSCHALK
Original assignee: Kirchner & Wilhelm Gmbh + Co Kg
Priority date: 2018-04-13
Filing date: 2019-03-28
Publication date: 2019-10-17
Also published as: EP3773226A1; DE102018205672A1; EP3773226B1; DE102018205672B4

Abstract

The invention relates to an intermediate element (1) for a stethoscope (40), wherein the intermediate element (1) comprises: - an input connection (2) for a first stethoscope part (11) which introduces sound from a stethoscope head (41); - an output connection (3) for a second stethoscope part (13) which guides sound to at least one ear interface (45a-b); - a connection channel (8) between the input connection (2) and the output connection (3) which can guide sound from the input connection (2) to the output connection (3); and - an electronic amplifier arrangement (5) comprising a) a microphone arrangement (14) for picking up sound obtained via the input connection (2), b) a loudspeaker arrangement (15) for outputting sound to the output connection (3), c) an electronic amplifier (16) using which signals picked up by the microphone arrangement (14) can be supplied to the loudspeaker arrangement (15) in an amplified manner, d) an energy storage device (17) for supplying the electronic amplifier arrangement (5) with electric current. The invention retroactively makes an electronic amplification function for stethoscopes available in a simple and cost-effective manner, and at the same time improves the operational readiness of the stethoscope.

Description

Intermediate link for retrofitting a mechanical stethoscope

The invention relates to an intermediate member for retrofitting a mechanical stethoscope with an electronic amplification function. Stethoscopes are used to make sound phenomena from the inside of bodies better audible. In particular, the sounds of internal organs of patients, such as the heart or lungs, can be monitored with a stethoscope (so-called "consultation") and thus provide information on the condition of these organs. Stethoscopes can also be used in mechanical engineering, for example, to check the function of a machine.

The most common stethoscopes are mechanical stethoscopes (also called acoustic stethoscopes). In these, the sound recorded by the body to be examined is transmitted mechanically from a stethoscope head via a tube to an ear interface, at which the examiner perceives the transmitted sound with his ear. The ear interface typically includes an earpiece for a respective ear of the examiner; the ear tips are typical arranged at the ends of two earhooks. The stethoscope head usually has a membrane resting on the body to be examined, or else a bell, which sits tightly against the body to be examined. An example of such a mechanical stethoscope is the Kircher COLORSCOP ^® Duo. Mechanical stethoscopes are available at comparatively low cost and are therefore widely used by both doctors and nurses.

Meanwhile, so-called electronic stethoscopes are used. In these, the sound emanating from the body to be examined is picked up with a microphone, amplified electronically and fed in an amplified form to the ear interface. Due to the amplification, even very quiet sounds can be made accessible for consultation. As part of the electronic amplification special filter functions can also be used, for example to reduce interference caused by ambient noise. An example of such an electronic stethoscope is the 3M Littmann ^® Model 3200 Electronic stethoscopes are so far relatively expensive and have only found a limited distribution, particularly in the medical field. In the known electronic stethoscopes, the amplification function is usually integrated in the stethoscope head.

A relevant problem is also the power supply of an electronic stethoscope. The electronic amplification function fails when the energy store of the electronic stethoscope is exhausted; until the battery is recharged or replaced, the electronic stethoscope is not ready for use. This has - in addition to the costs - limited the acceptance of electronic stethoscopes; Many physicians preferred to use a mechanical stethoscope that was always ready to be used in order to avoid having to wait until the beginning of an examination in an emergency. From WO 2015/105641 Al an adapter for a stethoscope with amplification function has become known, in which a first chamber with a microphone and a second chamber is formed with a speaker. The chambers are connected to each other via a switching valve. Object of the invention

It is an object of the invention to provide an electronic amplification function for stethoscopes in a simple and cost-effective manner subsequently available, and at the same time to improve the operational readiness of the stethoscope.

DESCRIPTION OF THE INVENTION This object is achieved according to the invention by means of an intermediate member for a stethoscope, wherein the intermediate member comprises

an input port for a first stethoscope part that brings sound from a stethoscope head,

an output connection for a second stethoscope part, which leads sound to at least one ear interface,

a connection channel between the input terminal and the output terminal that can carry sound from the input terminal to the output terminal, and

an electronic amplifier arrangement comprising

a) a microphone arrangement for receiving sound received via the input terminal,

b) a loudspeaker arrangement for emitting sound to the output terminal, c) an electronic amplifier with which signals picked up by the microphone arrangement can be amplified fed to the loudspeaker arrangement,

d) an energy store for supplying the electronic amplifier arrangement with electric current.

The present invention proposes an intermediate member (or intermediate component) which can be incorporated into a conventional mechanical stethoscope, in particular also subsequently.

With this intermediate element, an electronic amplification function can be used, if necessary or the examiner (such as a doctor or a doctor) a caregiver) wishes this. Preferably, with the amplifier arrangement, an amplification of the sound (sound pressure level) obtained at the input terminal can be achieved by a factor of at least 3, preferably by a factor of at least 10.

Alternatively, it is also possible to use the retrofitted stethoscope mechanically. For this purpose, a connecting channel is provided in the intermediate member, which connects the input terminal and the output terminal with each other and therefore allows a mechanical sound conduction between these terminals. Thus, it is in particular possible to still use the stethoscope when exhausting the energy storage of the electronic amplifier arrangement (although only as a mechanical stethoscope); a time-consuming search for a replacement stethoscope or a replacement battery is not necessary, especially in time-critical situations.

Input terminal and output terminal each have an opening for the entry or exit of the sound. The connection channel typically has an (inner) diameter DV which approximately corresponds to the (inner) diameter DST of a respective sound-carrying section of a connected stethoscope part, preferably where 1.2 * DST> DV> 0.8 * DST, so that the Sound propagate essentially undisturbed. The first stethoscope part typically includes a stethoscope head with a membrane for engagement with the body to be examined and / or a bell for placement on the body to be examined. The second stethoscope part typically includes at least one ear interface with an earpiece for the examiner's ear or ears. The input terminal and the output terminal preferably allow for airtight (and usually reversible) connection to the two stethoscope parts.

The intermediate member is typically formed substantially cylindrical, wherein the connecting channel extends substantially centrally parallel to the cylinder axis. The intermediate member is preferably made predominantly of plastic in order to obtain a low weight. Preferred embodiments of the invention

In a preferred embodiment of the intermediate element according to the invention, the microphone arrangement and the loudspeaker arrangement are arranged on the connection channel such that the microphone arrangement is closer to the input connection than the loudspeaker arrangement. Due to the arrangement of the microphone arrangement and the loudspeaker arrangement on the connecting channel, it is also used in the context of the amplification function. For unreinforced as well as for amplified noises, essentially the same sound paths in the intermediate element can be used, which facilitates the alternative evaluation or consultation of unreinforced and amplified noises. Positioning the microphone assembly farther forward (towards the stethoscope head) than the speaker assembly reduces unwanted feedback.

In an advantageous development of this embodiment, the microphone arrangement has a directional characteristic, so that the microphone arrangement registers sound arriving from the side of the input terminal more strongly than sound arriving from the side of the loudspeaker arrangement and the output terminal. This improves the amplification of the sounds from the body to be examined and reduces the influence of environmental noise, and further reduces unwanted feedback.

Equally advantageous is a further development in which the loudspeaker arrangement has a directional characteristic, so that sound transmitted by the loudspeaker arrangement is directed more towards the side of the output connection than to the side of the microphone arrangement and the input connection. This also reduces unwanted feedback to a considerable extent. Also preferred is a development in which a closure device is present, which can be switched between an open position and a closed position, the closure device being in the closed position. ment closes the connection channel between the microphone assembly and the loudspeaker arrangement, and in the open position the connection channel between the microphone arrangement and the loudspeaker arrangement is open. With the switchable shutter device, it is possible to further reduce the risk of feedback between microphone -An order and speaker assembly in electronic amplification operation; with closed Stel development of the closure device for this purpose, the connecting channel for sound is largely blocked. In order to be able to pass the sound freely from the input connection to the output connection in the unreinforced case, the closing device can be transferred to the open position.

It is preferably provided that the closure device is designed to be mechanically switchable manually,

in particular, wherein the closure device has a latch for the closed position and a latch for the open position. The ma nuell mechanical switching between open and closed position is also easily possible if the energy storage should be exhausted, and is also inexpensive and easy to set up. Due to the latching (which is usually set up via an elastic mechanism), good control over the position of the closure device is possible.

It is also preferred if the closure device is designed with an iris diaphragm, in particular wherein the iris diaphragm can be switched over by means of a rotatable actuating ring between the closed position and the open position. By means of an iris diaphragm, a closure of a connecting channel, in particular located centrally in the intermediate member, can take place in a space-saving manner. Switching over a rotatable actuating ring is easy to set up.

Also advantageous is an embodiment in which the input terminal and / or the output terminal are formed with

- a connection thread and / or

- A plug-in connection, in particular a conically shaped plug connection. Thread and plug connections have proven themselves in practice and are simple and reliably set up to connect the first and / or second stethoscope parts. Conically shaped plug-in connections also allow a certain flexibility in the connector sizes to be connected, for example to establish compatibility with various manufacturers of mechanical stethoscopes. Note that you can also use connection adapters on the connection threads or plug-in connections to compensate for differences in size.

Also preferred is an embodiment in which the input terminal and / or the output terminal are socket-shaped and / or pipe-socket-shaped, in particular wherein the input terminal is socket-shaped and the output terminal is pipe-socket-shaped. In conventional mechanical stethoscopes is usually the stethoscope head with a

pipe-socket-shaped plug connection formed, which can be introduced into a socket-shaped input terminal; In addition, an earhook end can easily be inserted into a socket-shaped input connection. On a pipe-socket-shaped output connection can easily be a sound tube or an ear olive flipped. Particularly preferred is an embodiment in which the electronic amplifier has at least one filter function that can be applied to the recorded signals, in particular

a frequency filter, preferably a switchable frequency filter for adapting to different forms of a stethoscope head and / or a frequency filter with a plurality of individually adjustable frequency ranges, and / or

- A subtraction filter for subtracting ambient noise, in particular wherein the intermediate member for determining ambient noise to be subtracted at least one further microphone, preferably wherein the at least one further microphone is arranged externally on the intermediate member. With a filter function relevant information from the sound of the examined body can be more easily recognized or made more perceptible. Forms of the stethoscope head to which an adjustment can be made are in particular a membrane type or a Giocken type.

Also advantageous is an embodiment in which the energy storage is designed as a rechargeable energy storage, in particular wherein the inter mediate member comprises a wireless charging device for the energy storage. A rechargeable energy store (also referred to as a rechargeable energy source) avoids time-consuming exchanges. A wireless charging device is particularly hygienic and avoids space consuming plug connec tions for energy transfer. The wireless charging means of the intermediate member typically receives power via an inductive coupling from an external power source. As an external energy source for the intermediate member, for example, a solar charging station or a charging station connected to the local power grid can be used.

Also preferred is an embodiment in which the intermediate member has

- At least one input device for adjusting the amplifier arrangement; and or

- A display for displaying a patient's noise, in particular a breath sound or a heartbeat, and / or

- An electronic analysis device for evaluating a patient's noise; and or

a display for displaying information derived from a patient's sound, in particular a heart rate or a respiratory rate, and / or

- A display for displaying a remaining energy supply of the energy storage or warning when reaching a critical remaining energy supply of the energy storage; and or

a display for representing a gain of the electronic amplifier arrangement; and or

a display for displaying a frequency filter setting; and or

a display for displaying an adjustment of ambient noise compensation; and or

a wireless data transmission interface, in particular for WLAN or Bluetooth; and or

a wired data transmission interface, in particular for USB,

- An on / off switch for the electronic amplification device. These additional functions have proven themselves in practice and improve the practical use or facilitate the operation. By means of the on / off switch, the energy supply of the energy storage can be reliably protected.

The scope of the present invention also includes a stethoscope arrangement comprising

a mechanical stethoscope with a stethoscope head, a sound transmission tube, two earhooks and two ear interfaces,

- At least one inventive, described above intermediate member, wherein the at least one intermediate member between the stethoscope head and the two Ohrinterfaces is incorporated in the mechanical stethoscope. In this stethoscope arrangement, the stethoscope can be operated either with electronic amplification or mechanically. The upgrade with the intermediate member according to the invention is very easy.

Also within the scope of the present invention is the use of an inventive intermediate member described above for retrofitting a mechanical stethoscope,

wherein the intermediate member is installed between a stethoscope head and an ear interface of the stethoscope,

wherein a first stethoscope part comprising the stethoscope head is connected to the input port of the intermediate member, and a second stethoscope part comprising the ear interface is connected to the output port.

During retrofitting, the mechanical stethoscope is typically split between the first stethoscope part and the second stethoscope part, and the first stethoscope part and the second stethoscope part are reconnected to a whole stethoscope (or stethoscope assembly) by the intermediate member , The retrofitting can be done easily manually and within a few seconds. As a result, existing, mechanical stethoscopes can be inexpensively upgraded for electronic amplification, to quietly or, if necessary make inconspicuous sounds more accessible to an examination. At the same time, simple mechanical consultations remain possible without any problems, even if there is a lack of electricity. Preferred is a variant of the use according to the invention, wherein the intermediate member is connected to the input terminal with or without a connection adapter to the stethoscope head and the output terminal with or without a connection adapter to a sound transmission tube. At this point a central reinforcement for both ear interfaces is possible with an intermediate link.

In an alternative variant, it is provided that the intermediate member is connected to the input terminal with or without a connection adapter to one end of a Ohrbü gel and the output terminal with or without a connection adapter to a Ohrolive. In this variant, a separate intermediate member is typically used for each ear, so a total of two intermediate links. In this design, the amplified sounds provided by the speaker assembly are transmitted with a short path to the examiner's ear interface or ear, which often provides quality gains, especially when filter functions are employed.

Further advantages of the invention will become apparent from the description and the drawings. Likewise, according to the invention, the above-mentioned features and those which are further developed can each be used individually for themselves or for a plurality of combinations of any kind. The embodiments shown and described are not to be understood as exhaustive enumeration, but rather have exemplary character for the description of the invention. Detailed description of the invention and drawing

Fig. 1 shows a schematic perspective view of an embodiment of an intermediate member according to the invention;

FIG. 2 shows a schematic cross-sectional view of the intermediate member of FIG.

1, with the closure device in the closed position;

FIG. 3 shows a schematic cross-sectional view of the intermediate member of FIG.

1, with the closure device in the open position;

4 shows the use according to the invention of an intermediate element in the retrofitting of a mechanical stethoscope in a first variant, with (a) the mechanical stethoscope before the retrofitting; with (b) separating the mechanical stethoscope between the stethoscope head and the sound transmission tube, and with (c) the mechanical stethoscope with a built-in pontic;

5 shows the use according to the invention of two intermediate links in the retrofitting of a mechanical stethoscope in a second variant, with (a) the mechanical stethoscope before retrofitting; with (b) separating the mechanical stethoscope between the earhook ends and the ear-olives, and with (c) the mechanical stethoscope with two built-in pontics.

FIG. 1 shows, in a schematic perspective view, an intermediate member 1 according to the invention which can be used for retrofitting a mechanical stethoscope with an electronic amplification function according to the invention. The intermediate member 1 is constructed in the embodiment shown substantially circular cylindrical. At its left-hand end in FIG. 1, the intermediate member 1 has an input connection 2, which is designed here in the form of a socket with an associated opening for a plug connection to a first stethoscope part. At its right in Fig. 1 end, the intermediate member has an output terminal 3, which is here pipe socket-shaped with a corre sponding opening (hidden in Fig. 1) for a plug connection to a second stethoscope part. About the input terminal 2 sound, such as noise from the body of a patient, are introduced into the intermediate member 1. This sound can optionally be passed through the intermediate member 1 to the output terminal 3 without amplification, or be amplified by an electronic amplifier arrangement 5 in the intermediate member 1, in which case the amplified sound is fed to the output terminal 3.

On the intermediate member 1 a plurality of control buttons (input devices) 4a-4c are formed, with which the amplifier arrangement 5 can be set and operated; one of these operation buttons 4a also serves as an on / off switch. For example, the amplification factor ("volume") can be set via the control buttons 4a-4c, or a filter function with which, for example, ambient noise can be reduced can be preselected via a flat display 6, for example an LCD display. For example, the current settings of the amplifier arrangement 5 can be read, or even registered patient noises can be displayed graphically, or even an automatically measured heart rate can be displayed.

Furthermore, on the intermediate member 1, an actuating ring 7 (largely hidden in Fig. 1) formed with an actuating element 7a, with which a Verschlusseinrich device can be opened and closed (see Fig. 2). With the actuator 7a, the actuating ring 7 between a rotational position for the amplification operation ("ampl") and a rotational position for the unamplified, mechanical operation ("mech") can be adjusted manually. Fig. 2 and Fig. 3 show in schematic cross-section the internal structure of the intermediate member 1; In FIG. 2, an internal connection channel 8 between the input connection 2 and the output connection 3 is blocked by a closure device 9, whereas in FIG. 3 the connection channel 8 is opened when the closure device 9 is withdrawn.

In the sleeve-shaped input terminal 2, which is designed as a conically shaped plug connection with a conical surface 2a, a pipe socket-like, also conically shaped plug connection of a first stethoscope part 11 with a conical surface 11a can be introduced. With an O-ring 12 while an air-tight seal can be achieved.

At the pipe socket-shaped output terminal 3, which is designed as a conically shaped plug connection with a conical surface 3a, a socket-like, also conically shaped plug connection of a second stethoscope part 13 with a conical surface 13a can be placed. The material of the adjoining second stethoscope part is here made of elastic rubber, and a radially inwardly projecting bead can engage in a recess 21 on the output port 3 in order to achieve an airtight seal on this side as well.

The inner diameter DST of the sound conducting sections in the stethoscope parts 11, 13 correspond here to the inner diameter DV in the connecting channel 8; in the inserted / plugged state (indicated by dashed lines) of the stethoscope parts 11, 13, there are no noticeable steps in the region of the inner wall of the connecting channel 8 or the transitions to the stethoscope parts 11, 13.

However, two directional channels 14a, which belong to the two microphones of a microphone arrangement 14, branch off from the connecting channel 8 in the embodiment shown. The straightening channels 14a extend as seen here from the side of the input terminal 2 at an angle of about 45 ° relative to the axis (longitudinal axis) of the connecting channel 8, so that from the input terminal side penetrating sound can easily get to the microphones of the microphone assembly 14, but not any penetrating from the output terminal side forth sound. Furthermore branch off from the connecting channel 8 in the embodiment shown depending Weil two more directional channels 15 a, which belong to the two speakers of a speaker assembly 15. As seen here, the directional channels 15a run from the side of the input terminal 2 at an angle of approximately 135 ° with respect to the axis of the connecting channel 8, so that sound emitted by the loudspeakers can easily reach the output terminal 3, but not to the microphones of the microphone arrangement 14th

Between the microphone arrangement 14 and the loudspeaker arrangement 15, the connection channel 8 with the closure device 9 can be blocked. The closure device 9 is here designed with an iris diaphragm which comprises a plurality of diaphragm elements 9a. The diaphragm elements 9a are movably mounted on the intermediate member 1 via fixed axle pins 9b; the fixed axle pins 9b are distributed annularly around the connecting channel 8. Movable guide pins 9c, which in turn are mounted on the actuating ring 7, also engage in the diaphragm elements 9a. By rotating the actuating ring (about an axis which is parallel to the connecting channel 8), the pivotal position of the diaphragm elements 9a can be changed about the fixed axle pins 9b, and thereby the opening width of the iris diaphragm can be changed. In the position shown in Fig. 2, the iris of the shutter 9 is completely closed, and the mechanical sound conduction through the connection channel 8 is minimized. This position is optimal for the electronic amplification operation. In the position shown in FIG. 3, the iris diaphragm is opened so far that its opening width corresponds to the inner diameter DV of the (remaining) connection channel 8; the sound conduction through the connecting channel 8 is unimpaired. This position is optimal for mechanical (unreinforced) operation. In electronic amplification operation, the electronic amplifier arrangement 5 is operated. Via the microphone arrangement 14, incoming sound (containing patient noises) from the input terminal 2 is registered _; Amplified amplified in the electronic amplifier 16 and reproduced amplified through the speaker assembly 15 and so fed to the output terminal 3. The power supply of the amplifier arrangement 5 ensures an energy storage 17, in this case a rechargeable battery. The energy store 17 can be charged via a wireless charging device 18, which can receive energy from an external electromagnetic field on an induction coil; the state of charge of the energy storage 17 can be indicated on the display 6. The amplifier 16 is here integral with an electronic control and evaluation device, with the commands from the control buttons 4a -4c can be received, or the display 6 can be controlled, and also the recorded signals can be processed or evaluated. In particular, the amplifier 16 may receive ambient noise information from another microphone 19 so that when amplifying the noise received at the microphone assembly 14, portions of environmental noise may be deducted, specifically targeting patient noise (and not environmental noise). can be strengthened. The further microphone 19 is arranged on the outside of the intermediate member 1 ("external microphone") .In the embodiment shown, the amplifier 16 also has a WLAN connection 20 in order to wirelessly transmit, for example, recorded patient noises to an external computer the amplification function via completely deakti fourth, wherein the amplifier arrangement via the control knob 4a is turned off.

Optionally, the intermediate member 1 can be equipped with a GPS receiver (not shown in more detail) with which the location of the intermediate member 1 can be determined and transmitted to an external receiver. As a result, the intermediate member 1 can be easily recovered, such as in the case of theft. FIG. 4 shows the retrofitting of a mechanical stethoscope 40 in a first variant of the invention.

In part of Figure (a), a conventional mechanical stethoscope 40 is first seen, which can be retrofitted within the scope of the invention. The mechanical stethoscope 40 has a stethoscope head 41, to which a sound transmission tube 42 is connected. In the embodiment shown, the sound transmission tube 42 branches onto two earloops 43a, 43b (in other embodiments, the sound transmission tube can also terminate, for example, at a manifold, which in turn is connected to two earloops). At the end of a respective earloop 43a, 43b, ear earplugs 44a, 44b are attached as ear interfaces 45a, 45b. The ear tips 44a, 44b are hung by an examiner in a front part of the ear canal of his ears.

The stethoscope head (also called chest piece) 41 may be in particular of the membrane type (also called "flat head stethoscope") or of the bell type (also called "T richter stethoscope"), or a combination of both types (also "double head Called "stethoscope").

For the retrofitting of the mechanical stethoscope 40 is provided in the first variant, the stethoscope 40 between stethoscope head 41 and sound transmission tube 42 to separate, see. Figure (b). The stethoscope head 41 then forms a first stethoscope part 11, and the remaining stethoscope (with sound transmission tube 42, ear hooks 43a, 43b and ear tips 44a, 44b) forms a second stethoscope part 13. Between the first stethoscope part 11 and second stethoscope part 13, an intermediate member 1 is inserted. In this case, the stethoscope head 41 is connected to the input connection (plugged in here), and the sound transmission tube 42 is connected to the output connection (plugged in here). As a result, a stethoscope arrangement 46 is obtained, cf. Figure (c), which can be used both mechanically (unamplified) and with electronic amplification to listen to a patient. Reinforced sound is delivered here by the intermediate member 1 in the sound transmission tube 42, wherein the amplified sound distributed to both Ohrinterfaces 45a, 45b.

FIG. 5 shows the retrofitting of a mechanical stethoscope 40 in a second variant of the invention. Figure (a) first shows again the mechanical stethoscope 40 before retrofitting.

For the retrofitting of the mechanical stethoscope 40 is provided in the second variant, the stethoscope 40 between the ends of the earhooks 43a, 43b and the ear tips 44a, 44b to separate, see. Figure (b). The ear tips 44a, 44b each form a second stethoscope part 13, and the remaining stethoscope (with stethoscope head 41, sound transmission tube 42 and ear hooks 43a, 43b) forms a first stethoscope part 11. Between the first stethoscope part 11 and respective second one Stethoscope part 13, an intermediate member 1 is inserted in each case; in total, two separate intermediate links 1 are thus inserted into the mechanical stethoscope 40 here. In this case, the respective ear hook 43a, 43b is connected to the input terminal (plugged in here), and the respective ear olive 44a, 44b is connected to the output terminal (attached here). As a result, a stethoscope arrangement 46 is obtained, cf. Figure (c), which can be used both mechanically (unamplified) and with electronic amplification to monitor a patient. Un amplified sound is distributed here via the branched sound transmission tube 42 to the ear hooks 43a, 43b, and a respective part of the unamplified sound is then amplified by one of the intermediate links 1 and the respective amplified sound is provided at the respective ear interface 45a, 45b. Bezuaszeichenliste

1 intermediate link

2 input connection

3 output connection

4a Control knob / input device / on / off switch 4b-c Control knob / input device

5 electronic amplifier arrangement

6 display

7 actuating ring

7a actuator

8 connecting channel

9 closure device

9a aperture element

9b axle pin

9c guide pin

11 first stethoscope part

11a cone surface

12 o-ring

13 second stethoscope part

13a cone surface

14 microphone arrangement

14a straightening channel

15 speaker arrangement

15a straightening channel

16 electronic amplifier

17 energy storage (here battery)

18 wireless charging device

19 additional microphone (external microphone)

20 WLAN connection

21 deepening

40 mechanical stethoscope for retrofitting

41 stethoscope head 42 sound transmission hose

43a-b earhook

44a-b Ohrofive

45a-b ear interface

46 stethoscope arrangement

DST (inner) diameter in the first / second stethoscope part

DV (inner) diameter in the connection channel

Claims

claims

1. intermediate member (1) for a stethoscope (40), wherein the intermediate member (1)

- An input terminal (2) for a first stethoscope part (11), the

Introducing sound from a stethoscope head (41),

an output terminal (3) for a second stethoscope part (13), which leads sound to at least one ear interface (45a-b),

a connection channel (8) between input terminal (2) and output terminal (3), which can conduct sound from the input terminal (2) to the output terminal (3), and

- An electronic amplifier arrangement (5), comprising

a) a microphone arrangement (14) for receiving sound received via the input terminal (2),

b) a loudspeaker arrangement (15) for emitting sound to the output terminal (3),

c) an electronic amplifier (16), with which the signals picked up by the microphone arrangement (14) can be fed to the loudspeaker (15) amplified,

d) an energy store (17) for supplying the electronic amplifier arrangement (5) with electric current.

Second intermediate member (1) according to claim 1, characterized in that

in that the microphone arrangement (14) and the loudspeaker arrangement (15) are arranged on the connection channel (8) such that the microphone arrangement (14) is closer to the input connection (2) than the loudspeaker arrangement (3).

3. intermediate member (1) according to claim 2, characterized in that the microphone arrangement (14) has a directional characteristic, so that the Microphone arrangement (14) from the side of the input terminal (2) incoming sound more registered than from the side of the speaker assembly (15) and the output terminal (3) incoming sound. 4. Intermediate member (1) according to claim 2 or 3, characterized in that the loudspeaker arrangement (15) has a directional characteristic, so that from the loudspeaker arrangement (15) emitted sound is directed more strongly to the side of the output terminal (3) to the side of the microphone assembly (14) and the input terminal (2).

5. intermediate element (1) according to one of claims 2 to 4, characterized in that a closure device (9) is present, which is switchable between an open position and a closed position, wherein the closure device (9) in the closed position, the connecting channel (8) between the microphone assembly (14) and the

Speaker assembly (15) closes, and in the open position, the connecting channel (8) between the microphone assembly (14) and the speaker assembly (15) is open. 6. intermediate member (1) according to claim 5, characterized in that

that the closure device (9) is formed manually mechanically switchable,

in particular, wherein the closure device (9) has a latch for the closed position and a latch for the open position.

7. Intermediate member (1) according to claim 5 or 6, characterized

the closure device (9) is formed with an iris diaphragm. 8. intermediate member (1) according to claim 7, characterized in that the iris diaphragm is switched over a rotatable actuating ring (7) between the closed position and the open position. Intermediate member (1) according to claim 8, characterized in that

in that the rotatable actuating ring (7) is formed with an actuating element (7a) with which the actuating ring (7) can be adjusted manually between a rotational position for a boosting operation and a rotational position for a mechanical, non-energized operation, in particular wherein the actuating element (7a ) protrudes radially relative to the remaining intermediate member (1).

10. Intermediate member (1) according to one of the preceding claims, characterized in that the input terminal (2) and / or the output terminal (3) are formed with

- a connection thread and / or

- A plug-in connection, in particular a conically shaped plug connection.

11. intermediate member (1) according to any one of the preceding claims, characterized in that the input terminal (2) and / or the output terminal (3) are formed bush-shaped and / or pipe socket-shaped.

12. Intermediate member according to claim 11, characterized in that the input connection (2) is bush-shaped and the output connection (3) is pipe-socket-shaped.

13. Intermediate member (1) according to one of the preceding claims, characterized in that the electronic amplifier (16) has at least one filter function which can be applied to the recorded signals, in particular

a frequency filter, preferably a switchable frequency filter for adaptation to different forms of a stethoscope head (21) and / or a frequency filter with a plurality of individually adjustable frequency ranges, and / or

a subtraction filter for subtracting ambient noise, in particular wherein the intermediate element (1) for determining ambient noise to be subtracted comprises at least one further microphone (19) Preferably, wherein the at least one further microphone (19) outside on the intermediate member (1) is arranged.

14. Intermediate member (1) according to one of the preceding claims, characterized in that the energy store (17) is designed as a rechargeable energy store (17), in particular wherein the intermediate member (1) is a wireless charging device (18) for the energy store (17). includes. 15. Intermediate member (1) according to one of the preceding claims, characterized in that the intermediate member (1)

- At least one input device (4a-c) for adjusting the amplifier arrangement (5); and or

- A display (6) for displaying a patient's noise, in particular a breath sound or a heartbeat, and / or

- An electronic analysis device for evaluating a patient's noise; and or

- A display (6) for displaying an information derived from a patient noise from, in particular a heart rate or a respiratory rate, and / or

- A display (6) for displaying a remaining energy supply of the energy storage device (17) or for warning upon reaching a critical ver remaining energy supply of the energy store (17); and or

a display (6) representing a gain of the electronic amplifier arrangement (5); and or

a display (6) for displaying a frequency filter setting; and or

a display (6) for displaying an adjustment of ambient noise compensation; and or

a wireless data transmission interface, in particular for WLAN (20) or Bluetooth; and or

a wired data transmission interface, in particular for USB,

- An on / off switch (4a) for the electronic amplification device (5).

Intermediate member (1) according to one of the preceding claims, characterized in that

that the intermediate member (1) is made predominantly of plastic, in particular of a sound-insulating plastic.

17. Intermediate member (1) according to one of the preceding claims, characterized in that the intermediate member (1) has an outer shell made of plastic, in particular of a sound-insulating and / or rubber-elastic plastic.

18. pusher (1) according to one of the preceding claims, characterized

the microphone arrangement (14) and the loudspeaker arrangement (15) are arranged on the connection channel (8) such that the microphone arrangement (14) is closer to the input connection (2) than the loudspeaker arrangement ( 3)

in that the microphone arrangement (14) has a directional characteristic, so that the microphone arrangement (14) registers sound arriving from the side of the input connection (2) more strongly than from the side of the loudspeaker arrangement (15) and the output connection (3). incoming sound, and the speaker assembly (15) has a directional characteristic, so that the sound from the speaker assembly (15) emitted sound is directed to the side of the output terminal (3) as the side of the microphone assembly (14) and the input terminal (2)

wherein the microphone arrangement (14) and the loudspeaker arrangement (15) include directional channels (14a, 14b, 15a, 15b) which branch off from the connection channel (8),

and that the electronic amplifier (16) has at least one filter function which can be applied to the recorded signals, namely a subtraction filter for subtracting ambient noise, and the intermediate member (1) has at least one further microphone (19) for determining environmental sounds to be subtracted . the outside of the intermediate member (1) is arranged.

19. Intermediate member (1) according to one of the preceding claims, characterized in that the microphone arrangement (14) and the loudspeaker arrangement (15) comprise directional channels (14a, 14b, 15a, 15b) which branch off from the connection channel (8) and obliquely to the connecting channel (8),

in particular wherein the straightening channels (14a, 14b, 15a, 15b) extend at an angle of approximately 45 ° and at an angle of approximately 135 ° with respect to an axis of the connecting channel (8).

20. stethoscope assembly (46) comprising

a mechanical stethoscope (40) having a stethoscope head (41), a sound transmission tube (42), two earhooks (43a-b) and two ear interfaces (45a-b),

- At least one intermediate member (1) according to one of claims 1 to 19, wherein the at least one intermediate member (1) between the stethoscope head (41) and the two Ohrinterfaces (45a-b) is incorporated in the mechanical stethoscope (40).

21. Use of an intermediate member (1) according to one of claims 1 to 19 for retrofitting a mechanical stethoscope (40),

wherein the intermediate member (1) is installed between a stethoscope head (41) and an ear interface (45a-b) of the stethoscope (40),

wherein a first stethoscope part (11) comprising the stethoscope head

(41) is connected to the input terminal (2) of the intermediate member (1), and a second stethoscope part (13) comprising the ear interface (45a-b) is connected to the output terminal (3). 22. Use according to claim 21, characterized in that the intermediate member (1) at the input terminal (2) with or without a terminals adapter to the stethoscope head (41) and the output terminal (3) with or without a connection adapter to a sound transmission tube (42) is connected.

23. Use according to claim 21, characterized in that the intermediate member (1) at the input terminal (2) with or without a connection adapter to one end of an earhook (43a-b) and at the output terminal

(3) with or without a connection adapter connected to an earpiece (44a-b).